Concerns About Propranolol: Side Effects and When to Stop Medication

I would like to ask a question about antiarrhythmic medications?

A few days ago, I went for an examination due to slight hand tremors and was prescribed 245 mg of propranolol to take twice daily.
The next morning, after taking the medication, I experienced several side effects, including dizziness, fatigue, bradycardia, and shortness of breath while walking.
After some time, as the medication's effects diminished, my heart rate returned to normal.
Should I consider stopping the medication due to these side effects?

Zhang, 10~19 year old female. Ask Date: 2018/06/30

Dr. Jiang Junyi reply Neurology

Hello, based on your description, the action of Propranolol is to reduce sympathetic nervous system activity.
Our autonomic nervous system is regulated by the sympathetic and parasympathetic nervous systems, where one acts as the accelerator and the other as the brake.
The sympathetic nervous system is responsible for accelerating the heart rate, engaging in fight-or-flight responses, while the parasympathetic nervous system is responsible for decelerating the heart rate, allowing the body to rest.
For example, during exercise, the sympathetic nervous system is activated, leading to an increased heart rate, faster breathing, and increased sweating.
Once the exercise stops, the parasympathetic nervous system begins to take effect, slowing the heart rate, reducing breathing rate, and decreasing sweating.
This can lead to the symptoms you mentioned, such as dizziness and a slowed heart rate.

When treating tremors, it is important to check for abnormalities in the thyroid or electrolytes.
If the tremor symptoms improve but side effects are significant, it is advisable to consider reducing the dosage by half.
Propranolol should not be abruptly discontinued after long-term use; a tapering process is recommended.
I suggest discussing your examination and treatment options with your primary physician.
Wishing you good health and peace.
Dr.
Jiang from Taoyuan Hospital cares about you.

Reply Date: 2018/06/30

More Info

Propranolol is a non-selective beta-blocker that is commonly used to treat various conditions, including hypertension, anxiety, and certain types of tremors. While it can be effective in managing these conditions, it is also associated with a range of side effects that can be concerning for patients. Your experience with side effects such as dizziness, fatigue, bradycardia (slow heart rate), and shortness of breath after starting propranolol is not uncommon.
The side effects you mentioned can occur due to the way propranolol works. By blocking beta-adrenergic receptors, propranolol reduces heart rate and cardiac output, which can lead to symptoms like dizziness and fatigue, especially when starting the medication or increasing the dose. Bradycardia can also be a direct effect of the medication, and while a heart rate of 60 beats per minute is generally considered acceptable, if you are experiencing symptoms like dizziness or shortness of breath, it is essential to take these seriously.

In terms of when to stop taking propranolol, it is crucial to consult with your healthcare provider before making any changes to your medication regimen. Abruptly stopping propranolol, especially after long-term use, can lead to withdrawal symptoms, including rebound hypertension and increased heart rate. Therefore, if you are experiencing significant side effects, it is advisable to discuss these with your doctor. They may suggest adjusting the dosage or switching to a different medication that may be better tolerated.

It is also important to consider the context of your symptoms. If you have a history of anxiety or tremors, propranolol may be beneficial in managing those symptoms, but if the side effects are overwhelming, the risks may outweigh the benefits. Your healthcare provider can help assess your overall health, the severity of your symptoms, and whether the benefits of continuing propranolol outweigh the side effects you are experiencing.

In summary, while propranolol can be effective for many patients, it is essential to monitor for side effects and communicate openly with your healthcare provider about any concerns. If you are experiencing significant side effects, do not hesitate to reach out to your doctor for guidance on the best course of action. They can help determine whether it is appropriate to continue, adjust, or discontinue the medication based on your individual health needs and response to treatment.

Similar Q&A

Understanding the Side Effects of Propranolol HCL: What You Need to Know

Hello: What are the side effects of Propranolol HCL?

Dr. Liu Huiya reply Pharmacology
Hello: Common side effects of using propranolol HCL include dizziness, lightheadedness, or a slight decrease in heart rate, which are usually mild and do not require discontinuation of the medication. However, if the above symptoms become pronounced, or if there are persistent or...

Understanding Propranolol: Managing Heart Issues and Side Effects

Hello: Last March, I went to the emergency room due to hyperventilation, and since then, I have undergone a series of tests. During this time, I have experienced shortness of breath, excessive anxiety, and extreme fatigue during episodes. Recently, a cardiologist discovered that ...

Dr. He Dongjin reply Cardiology
Hello, it is not advisable to abruptly stop medication. This refers to patients who have been taking a large amount of medication for a long time. Symptoms that resemble excessive sensitivity of the autonomic nervous system may not be related to the medication and could be diffic...

Understanding Propranolol and Other Medications for Chronic Pain Relief

Hello: Due to long-term neck and back pain, I have been taking Propranolol, Bromazepam, Chlorzoxazone, Alepam, and Deanxit for about six months. When I stop taking the medication, the pain becomes unbearable, so I don't know what to do. I'm also worried about potential ...

Dr. Gu Zhenting reply Pharmacology
The medications you are taking are intended to alleviate your pain. Here are the actions and precautions for each medication: Propranolol Indications: Treatment of hypertension, arrhythmias, angina, migraines, tremors, and pheochromocytoma. Side effects: Bradycardia, altered...

Managing Side Effects of Lurasidone: What to Do When You Feel Unwell

Hello Doctor: Yesterday I was prescribed Propranolol, but this morning I was completely unable to function due to dizziness. In the afternoon, I took Ritalin, and by the evening, I felt very fatigued. It seems that the effects of yesterday's medication are wearing off. I nee...

Dr. Lin Mianzhang reply Psychiatry
Hello Ms. Chang: Thank you for your hard work! Many people experience fatigue and drowsiness as side effects from taking Lipitor, which usually improve after a few days to a few weeks of medication. If the discomfort persists, I recommend that you try reducing the dosage by half ...